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Report outlines innovative breast cancer rehabilitation model
Experts recommend surveillance approach to rehabilitative care

ATLANTA—April 10, 2012—A new supplement in the journal Cancer outlines an innovative model to address a wide range of physical issues faced by women with breast cancer and offers hope for improved function and full participation in life activities for patients through rehabilitation and exercise. A panel of experts proposes a prospective surveillance model (PSM) that could reduce the incidence and severity of breast cancer treatment-related physical impairments. The model was developed over the past year by a panel of internationally known experts, with the support of the American Cancer Society and input from national healthcare professional organizations and advocacy groups.

The supplement says the current model of care for people with breast cancer focuses on treatment of the disease, followed by ongoing surveillance to detect recurrence. That approach, says the supplement, lacks attention to patients' physical and functional well-being. Breast cancer patients experience common impairments including pain, fatigue, upper extremity dysfunction, lymphedema, weakness, joint arthralgia, neuropathy, weight gain, cardiovascular effects, and osteoporosis. And even when these impairments lead to functional limitation, rehabilitation referral is lacking.

The supplement points to evidence that supports the implementation of a prospective surveillance model for early identification and treatment of physical impairments that may prevent or mitigate many of these functional concerns as well as provide a venue to point patients towards exercise and other health promoting activities. The goals of the model are to promote surveillance for common breast cancer-related physical impairments and functional limitations, to provide education to facilitate early identification of impairments, to introduce rehabilitation and exercise intervention when physical impairments are identified, and to promote and support physical activity and exercise behaviors through the trajectory of disease treatment and survivorship.

The PSM is ultimately coordinated with disease treatment from diagnosis through follow-up to create a more comprehensive, multi-disciplinary approach to survivorship care. The purpose of the supplement is to invite consideration of the model as a means to achieve reduced impairment, improved function, and increased participation in exercise.


The supplement is available free online at:


Support for this meeting and supplement was provided by the American Cancer Society through The Longaberger Company®, a direct selling company offering home products including handcrafted baskets made in Ohio, and the Longaberger Horizon of Hope® Campaign, which provided a grant to the American Cancer Society for breast cancer research and education.

Kathryn H. Schmitz, PhD, MPH, FACSM 
University of Pennsylvania School of Medicine 
Abramson Cancer Center

Nicole L. Stout, MPT, CLT-LANA 
Breast Care Center 
Walter Reed National Military Medical Center

Jill Binkley, PT, MClSc, CLT 
TurningPoint Women's Healthcare

Robert A. Smith, PhD 
American Cancer Society

Kimberly Andrews 
American Cancer Society

Ann M. Berger, PhD, RN, AOCNS, FAAN 
University of Nebraska Medical Center

Kristin Campbell, PT, MSc, PhD 
The University of British Columbia

Andrea L. Cheville, MD 
Mayo Clinic

Carol Fabian, MD 
The University of Kansas Cancer Center

Lynn Gerber, MD 
George Mason University

Susan R. Harris, PhD, PT, FAPTA, FCAHS 
The University of British Columbia

Sandi C. Hayes, PhD 
Queensland University of Technology

Karin Johansson, RPT, DrMedSci, 
Lund University and Skane University Hospital

Margie McNeely, M.Sc., P.T., PhD 
University of Alberta

Robert G. Prosnitz, MD, MPH 
The Hospital of the University of Pennsylvania

Andrea L. Pusic, MD, MHS, FRCSC 
Memorial Sloan-Kettering Cancer Center

Capt. Peter W. Soballe, MD 
Naval Medical Center San Diego

Wendy Demark-Wahnefried, PhD, RD 
University of Alabama at Birmingham Comprehensive Cancer Center

Michael D. Stubblefield, MD 
Memorial Sloan-Kettering Cancer Center

Kerri Winters-Stone, PhD, FACSM 
Oregon Health and Science University